The NHS - a powerhouse for new medicines?
- Published
Could the National Health Service help the UK lead the way in personalised medicine and digital healthcare technology?
That's the enticing prospect held out by ministers as they unveil initiatives weeks before the end of this parliament.
At the heart of the vision is genomics - the analysis of an individual's complete set of genetic information.
Its been announced that members of two families have been diagnosed with rare conditions as a result of an analysis of their genomes - they will now be eligible for personalised treatment.
There is great enthusiasm about the 100,000 genome project, which aims to sequence that number of genomes from NHS patients by 2017.
The health service is seen to be in the unique position of having access to a lifetime of medical records for a patient and that person's genome data.
As an integrated healthcare system with tens of millions of patients, it has been argued that the NHS is well placed to exploit the immense potential of genomics.
Track record
The life sciences minister George Freeman and the NHS England medical director Sir Bruce Keogh are among the enthusiasts for the 100,000 genome project.
Mr Freeman, who was involved in venture capital for the biotechnology industry before entering parliament, believes that the US healthcare system can't develop genomics in the same way as the NHS.
Sir Bruce has argued that American insurers will use individuals' genomic information to levy differential insurance premiums depending on the perceived risk - that would not happen in the NHS.
It is acknowledged by NHS chiefs, however, that the US has a better track record when it comes to fast-track approvals of news drugs.
Under the US Food and Drug Administration's critical path initiative, the process of transforming scientific discoveries into licensed medicines has been greatly accelerated.
Ministers, frustrated by the sometimes lengthy process on this side of the Atlantic, now want to make amends.
'In the loop'
George Freeman has now set up an accelerated access review, led by Sir Hugh Taylor, Chair of Guy's and St. Thomas' NHS Foundation Trust, to look at speeding up the availability of innovative medicines and treatments.
Underlying this is an awareness that new drugs can be licensed relatively quickly by the Medicines and Healthcare Products Regulatory Agency (MHRA) but getting them approved for use in the health service by the National Institute for health and Care Excellence (NICE) can take a lot longer.
The hope in Whitehall is that the review will result in companies who are developing new drugs and therapies getting an earlier indication from regulators that approvals will fall into place if clinical trials are successful.
NHS commissioners would also be in the loop at an earlier stage.
The theory is that a combination of fast track regulation and more certainty of having the NHS as a customer would provide a huge incentive for investors in British research.
For the taxpayer there would be benefits through this process. Quicker drug development means cheaper drugs, so the theory goes.
The traditional lengthy pathway from laboratory discovery to blockbuster drug was a costly one for big pharmaceutical companies.
The new world of personalised targeted medicines should mean lower development costs.
Changing landscape
Pharma companies, unhappy with the recent restrictions imposed on the Cancer Drugs Fund (CDF), may be sceptical about the brave new world which is being talked up by ministers.
The industry says its increasingly frustrated with the current system and has called for reform of the CDF and NICE.
The role of the Cancer Drugs Fund will be considered by the Taylor review.
It has the potential to herald major changes in the landscape for medical research and the purchasing of drugs by the NHS.
Watch this space.
- Published23 October 2014